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| SPOTLIGHT |
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| Year : 2023 | Volume
: 7
| Issue : 1 | Page : 49-51 |
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Improving fitness through exercise will improve our heart and mind
Carl J Lavie1, Icey Zhang2, Doris Yang2, Meiyan Liu3
1 Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA
2 Editorial Department, Asia-Pacific Office of Heart and Mind, Beijing, China
3 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| Date of Submission | 26-Dec-2022 |
| Date of Acceptance | 10-Jan-2023 |
| Date of Web Publication | 13-Mar-2023 |
Correspondence Address:
Prof. Meiyan Liu
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/hm.hm_59_22
In the interview, Prof. Carl “Chip” J. Lavie gave suggestions on daily exercise, shared impressive cases of cardiovascular disease (CVD) patients, gave professional explanations of weight management and CVD outcomes, etc. His major viewpoints are: (a) psychological stress is a major risk factor for CVDs, (b) a low-level physical activity contributes to a high prevalence of most CVD risk factors, and regular exercise training can improve cardiac function and aerobic performance, and (c) the prognosis and survival among CVD patients with low physical activity are better in the obese than the lean.
Keywords: Cardiovascular disease, exercise, obesity, psychological stress
How to cite this article:
Lavie CJ, Zhang I, Yang D, Liu M. Improving fitness through exercise will improve our heart and mind. Heart Mind 2023;7:49-51 |
| Foreword | |  |
The “new” world getting rid of the COVID-19 pandemic and its restrictions will take time to recover. In the past 3 years featuring “lockdown” and “work from home,” outside-door activities shrunk while sedentary time spiked. An increasing number of populations suffer from obesity and poor mental health, including depression and anxiety.
With the upward demand for therapies for recovery in physiology and psychology, we are honored to interview Prof. Carl “Chip” J. Lavie, one of the biggest names worldwide in cardiology and exercise. Prof. Lavie is Professor of Medicine and Medical Director of Cardiac Rehabilitation and Preventive Cardiology, Director of Exercise Testing Laboratory at the John Ochsner Heart and Vascular Institute. He has wide-ranging experience in cardiology, exercise, and psychology and is willing to give thoughtful advice from daily exercise routines to medical treatments.
The interview is recorded authentically and edited as follows. We do hope to provide an enjoyable and fruitful reading.
| Interview Record | | |
Question 1
You are a pioneer and an expert in exercise and cardiovascular disease (CVD), and many people are curious about your physical habits. What kind of exercise do you prefer in daily life?
Prof. Lavie: I run every day and average over 30 miles or over 50 km per week, and also do 1–2 10–15 min sessions per week of resistance exercise.
Question 2
You have been dedicated to the research of exercise and CVD for decades. Among all of your excellent publications and achievements, what are the most important to you?
Prof. Lavie: My leading achievements have been promoting the field of cardiac rehabilitation and secondary prevention,[1] demonstrating the importance of psychological stress in CVD,[2] showing the importance of the obesity paradox[3],[4] and the role that physical activity (PA) and fitness have in this, as well as promoting the importance of PA and fitness for prognosis,[5] especially in the COVID-19 era.[6] I currently have 1,090 papers on PubMed as of February 1, 2023, and 83 of these papers are COVID-19 ones.
Question 3
Could you please share some patients or cases that impressed you most in your clinical and teaching experience?
Prof. Lavie: Seeing how some patients who were sedentary, low fitness, obese, and with high depression and stress were able to improve with exercise and increasing their fitness and seeing them doing well for many years.
Question 4
Nordic walking seems popular lately. Could you please talk about how it may affect the body? Which group of people are recommended for this kind of exercise?
Prof. Lavie: The addition of Nordic poles to moderate to vigorous intensity walking is a simple, accessible option to enhance improvements in walking capacity, increase energy expenditure, engage upper body musculature, and improve other functional parameters such as posture, gait, and balance. In a simplified way, this is sort of like how a cane or walker may help very frail elderly improve their ability to walk and walk faster. This is very applicable to middle-aged and older people in cardiac rehabilitation. There were papers on this in my Journal, Progress in Cardiovascular Diseases,[7] and in the Canadian Journal of Cardiology, where I am on the Editorial Board, and I wrote the Editorial for this paper.[8]
Question 5
The view of “obesity” in your medical book, The Obesity Paradox, is significant and means a lot to researchers and patients. Could you please give a brief introduction to PA and weight loss?
Prof. Lavie: Obesity increases CVD risk factors and CVD prevalence and mortality. However, once patients with obesity develop CVD, their prognosis and survival are better than the lean with the same CVD. The obesity paradox is only present in those with low PA and fitness, whereas, in those with high PA/Fitness, the prognosis is excellent regardless of body composition.[3],[9]
Question 6
From the perspective of psycho-cardiology, what do you think are the important effects of exercise on heart and mental health? For example, what's the interaction between exercise and cardiac rehabilitation, stress relief, etc.?
Prof. Lavie: Psychological stress is a major risk factor to develop CVD and worsens the prognosis in CVD patients. This is especially true for depression, but other stress may also be important. We have published that cardiac rehabilitation and exercise reduces depression and other stress and reduces stress-induced mortality, and this is especially noted when fitness is improved.[10],[11],[12]
Question 7
What kind of physician, cardiologist in particular, do you expect in the future? What professional skills and medical literacy are necessary for a qualified cardiologist?
Prof. Lavie: All physicians, especially those in CVD, should recognize the importance of PA, exercise, and fitness and the role of psychological distress on health and longevity.
Question 8
You hold critical positions in many high-impact journals, including Mayo Clinic Proceedings, Progress in Cardiovascular Diseases, Current Problems in Cardiology and Progress in Preventive Medicine, and so on. Could you please give some advice for the development of Heart and Mind?
Prof. Lavie: Have a well-published editorial board, recruit good authors and papers, and be patient, as top authors want to publish in top Journals, and it takes time for a young journal to build its reputation and success.
| Editor's Note | | |
Prof. Lavie is a renowned expert in exercise around the world. His entire research life has been dedicated to cardiology and PA, and he found that considerable evidence supports the benefits of PA, exercise training, and fitness to the primary and secondary prevention of CVDs and cardiac rehabilitation. In our interview, Prof. Lavie was so patient and gave intelligent answers on the latest views of his research fields. Here are three significant viewpoints he has concluded:
- Psychological stress is a major risk factor for the pathogenesis and progression of CVDs[13] and worsens the prognosis in CVD patients, which is especially true for depression.
- Low levels of physical activity contribute to a high prevalence of most CVD risk factors, including hypertension, type 2 diabetes, obesity, metabolic syndrome, and depression,[10] while regular exercise training can attenuate cardiac function and aerobic performance weakened by aging and improve multiple mechanisms related to CVDs.[12]
- Weight loss and management is an ideal method in preventing CVD, yet not for adverse short-term CVD outcomes.[3] Among CVD patients with low PA/Fitness, the prognosis and survival are better in the obese than the lean.[10],[11],[12]
Carl Lavie, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, Louisiana, USA. [email protected]
Financial support and sponsorship
Nil.
Conflicts of interest
Prof. Carl J. Lavie is the Associate Editor-in-Chief of the Heart and Mind journal. Prof. Meiyan Liu is the Executive Editor-in-Chief of the Heart and Mind journal. Icey Zhang and Doris Yang are editorial staff of the Heart and Mind journal. The article was subject to the journal's standard procedures, with peer review handled independently of Prof. Carl J. Lavie and the research groups. There are no conflicts of interest.
| References | | |
| 1. | Lavie CJ, Sanchis-Gomar F, Laukkanen JA. Fit is it for cardiovascular disease prediction, prevention, and treatment. Can J Cardiol 2021;37:193-5.  |
| 2. | OKeefe EL, Lavie CJ, Kachur SM. Novel comprehensive cardiac rehabilitation to combat the dose-dependent relationship between psychosocial stress and cardiovascular disease. Heart Mind 2020;4:109-15. [Full text] |
| 3. | Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2021;143:e984-1010. |
| 4. | GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017;377:13-27. |
| 5. | Carbone S, Kim Y, Kachur S, Billingsley H, Kenyon J, De Schutter A, et al. Peak oxygen consumption achieved at the end of cardiac rehabilitation predicts long-term survival in patients with coronary heart disease. Eur Heart J Qual Care Clin Outcomes 2022;8:361-7. |
| 6. | Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr 2020;14:779-88. |
| 7. | Reed JL, Terada T, Cotie LM, Tulloch HE, Leenen FH, Mistura M, et al. The effects of high-intensity interval training, Nordic walking and moderate-to-vigorous intensity continuous training on functional capacity, depression and quality of life in patients with coronary artery disease enrolled in cardiac rehabilitation: A randomized controlled trial (CRX study). Prog Cardiovasc Dis 2022;70:73-83. |
| 8. | Taylor JL, Popovic D, Lavie CJ. Exercise modalities and intensity to improve functional capacity and psychological/mental health in cardiac rehabilitation: A role for nordic walking? Can J Cardiol 2022;38:1135-7. |
| 9. | Lavie CJ. The Obesity Paradox: When Thinner Means Sicker and Heavier Means Healthier. NewYork: Hudson Street Press 2014. |
| 10. | Swift DL, Lavie CJ, Johannsen NM, Arena R, Earnest CP, O'Keefe JH, et al. Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention. Circ J 2013;77:281-92. |
| 11. | Sui X, Ott J Jr., Becofsky K, Lavie CJ, Ernstsen L, Zhang J, et al. Cardiorespiratory fitness and all-cause mortality in men with emotional distress. Mayo Clin Proc 2017;92:918-24. |
| 12. | Chow LS, Gerszten RE, Taylor JM, Pedersen BK, van Praag H, Trappe S, et al. Exerkines in health, resilience and disease. Nat Rev Endocrinol 2022;18:273-89. |
| 13. | Lavie CJ, Menezes AR, De Schutter A, Milani RV, Blumenthal JA. Impact of cardiac rehabilitation and exercise training on psychological risk Factors and subsequent prognosis in patients with cardiovascular disease. Can J Cardiol 2016;32:S365-73. |
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